1

HEALTH INSURANCE

2

ELIGIBLE DEPENDENTS Legal Spouse;

Unmarried children under age 26

An unmarried child who is physically or mentally incapacitated

Please note that an individual cannot be enrolled as a dependent under the Plan if he or she is enrolled as an employee.

A dependent cannot be enrolled under two Plan contracts at the same time.

3

PPO PLAN COMPARISON

Wellness ActivitiesAll

Three

Two Activities Completed

One Activity Completed

None

Smoking Attestation X X X   X      

PCP Selection X X   X   X    Health Assessment X   X X     X  Plan Options

Employer Share

Employee / Retiree Share

Enhanced 80/20

$448.11$13.5

6$28.5

6$28.56

$33.56

$43.56

$48.56

$48.56

$63.56

Consumer Directed

$448.11 $0.00$10.0

0$10.00

$20.00

$20.00

$30.00

$30.00

$40.00

Traditional 70/30

$448.11 $0.00

Dependent Premiums

Dependent GroupEnhanced 80/20

Consumer Directed

Traditional 70/30

Employee + Child(ren) $272.80 $184.60 $205.12Employee + Spouse $628.54 $457.68 $528.52Employee + Family $666.38 $506.64 $562.94

Total Employee Contribution = Active Employee Share + Dependent Premium

4

HEALTH CARE PREMIUMS & EFFECTIVE DATES

Employee hired 5/25/13.

(Emp can choose 6/1/13 or 7/1/13 as Effective Date of

Coverage.)

Employee selects PPO Standard (80/20) plan w/ Employee +

Children coverage.(Employee premium required)

Employee selects 6/1/13 as effective date of coverage.

ESS online Enrollment on

6/23/13

Enrollment not processed

for June payroll.

(No premium deducted in June for

June & July coverage)

3 month premiums deducted from July

paycheck.

(for June, July , & August coverage)

By choosing 7/1/13 as effective date of coverage, 2 month

premiums would be deducted from July

paycheck.

(for July & August coverage)

(No premium deducted in May for June coverage)

5

NC FLEX BENEFITS Health Care Flexible Spending Account

Dependent Day Care Flexible Spending Account

Dental Plan

Vision Care Plan

Critical Illness

Cancer Insurance

Voluntary Accidental Death & Dismemberment

Core AD&D

Voluntary Group Term Life

6

WHY PARTICIPATE? You can save about 25 - 40% or more on most

NCFlex benefits because your contributions are made on a pre-tax basis.

Participating in Flex is convenient since all benefits are payroll deducted (before taxes are withheld).

The choice to participate is yours. You can sign up for any or all of the plans offered. Each year you can then decide if you want to continue your participation.

7

EFFECTIVE DATES OF COVERAGE

Annual Enrollment held each year in October

Benefit elections effective January 1 of following year

New Hires – 30 days to enroll from date of hire

Life Events – 30 days to make a status change from date of the life event

8

REIMBURSEMENT PROCESSOPTION 1:

SUBMIT THE FORMOPTION 2:

CONVENIENCE CARD

Complete the FSA Claim Form (available at www.ncflex.org).

Attach copies of required documentation.

Mail or fax your FSA Claim Form (and attachments) to HCFSA Claims.

Reimbursements are usually processed within one week and are directly deposited into the same bank account that your paycheck is deposited.

Allows you to pay a provider/ vendor directly from your HCFSA at the point of purchase for eligible health care expenses.

Card reimburses up to your annual election.

Submit receipt documentation & Claim Form EXCEPT when transaction equals a copayment amount from your prescription, medical, dental, or vision plan.

9

QUALIFYING LIFE EVENTS

Marriage You or spouse

change from pt/full time

Divorce or Legal Separation

You or spouse take unpaid leave of absence

Death of a Spouse or Dependent

Spouse becomes employed/unemployed

Dependent loses eligibility

Birth /Adoption of Child Incapacitated Adult

becomes your Dependent

Other changes s permitted by IRS & State

If at any time during your Plan Year, any of the following events occur, you can change your Health Insurance, Dental Insurance &/or NCFlex coverage

10

NC HEALTHSMART

NC HealthSmart is an initiative by the State Health Plan to provide employees with resources and information to be as healthy as you can be.

Please visit the NC HealthSmart Wellness Programs link on the www.shpnc.org website to view a wealth of resources that can help you reach your health and wellness goals.

11

AGENCY SPECIFIC INSURANCE

In addition to the state-sponsored insurance programs, DPS can approve and make available other insurance options for DPS employees. These insurance programs are approved through the DPS Insurance Committee and are administered through private insurance agencies/brokers.

The supplemental agency-specific plans are NOT part of N.C. State Government and, therefore, are NOT transferable if you leave DPS and transfer to another State Agency.

Current Options: MetLife Dental

The MetLife dental insurance is comparable to the NC Flex high option dental plan.

12

AFFORDABLE CARE ACT Offers individuals to buy private health insurance

through a 'Health Insurance Marketplace‘.

This allows you to find private health insurance options to compare with the State's health coverage

In purchasing private insurance thru the Exchange, you may be eligible for a tax credit, which may result in a lower premium.

Please be aware that if you purchase a private health plan through the Exchange, you may lose your employer contribution to the health benefit plan offered by the State.

13

WORKERS COMPENSATION Provides medical benefits, compensation for lost

time from work and compensation for any permanent or permanent partial disability that results from a compensable job related injury.

Requires completion of a Form 19.

There are 3 types of workers’ comp leave: Salary Continuation/Injury Leave Leave of Absence-Workers Comp Injury Absence

While on approved workers’ compensation leave, employees continue to accumulate vacation and sick leave.

14

EMPLOYEE ASSISTANCE PROGRAM

The EAP Program is a contracted service with McLaughlin Young

The provide referrals and assistance on many issues: Personal Counseling Personal Health/Wellness Work/Life Services Elder Care Issues

There is no fee for the services provided by the EAP.

15

EAP ONLINE RESOURCEwww.mygroup.com

Username: NCDPSPassword: Guest